Activating the hard-to-reach: How one Medicaid
plan closed care gaps and reduced churn with targeted member engagement

A NOVUHEALTH CASE STUDY

Challenge

Like many Medicaid plans today, the large multi-state Medicaid plan in this case study struggled to engage its members and motivate them to actively participate in their health. Their efforts were complicated by the fact that Medicaid members are generally hard to reach—they are a widely diverse group and face numerous challenges that can be barriers to better health.

Historically, the plan had taken a one-size-fits all, mass-market approach to engagement. Members received only a mail-in checklist of health care activities they could attest to in order to receive a reward, and utilization was less than 1%.

After these less-than-stellar results, the plan realized it needed a targeted, member-centric approach to engagement, and chose to partner with NovuHealth.

Solution

NovuHealth designed 10 rewards and engagement programs—each tailored to a specific market—designed to engage more members, drive quality improvement, reduce churn and motivate preventive care. Each program used rewards and incentives to engage those not likely to participate in their health without incentive or encouragement, particularly pregnant women, new mothers, and children eligible for well-child visits, as well as high-risk and non-compliant members.

Unlike the plan’s previous approach, NovuHealth leveraged proprietary predictive analytics and propensity modeling to target specific populations within the plan’s membership and deliver personalized communications. We focused on engaging these members to complete high-value health care activities—those that matter most to plan performance and member health. Plus, we made engagement easier through a seamless member experience, offering members many ways to participate in the rewards program, such as mail, phone or online— whichever channel they preferred.

Results

The result was a highly targeted and effective program that delivered strong results across several measures. For example, member utilization—the percentage of targeted members who redeemed a health care activity for a reward—increased significantly. What’s more, 54.4% of previously non-compliant, hard-to-reach members closed their quality gaps. The program also had a notable impact on members’ decision to stay with the plan: members who engaged in the program had 27% less churn that those who did not actively participate.

In some markets, the impact was even more dramatic. In 3 states (which we’ll call Market 1, Market 2, and Market 3) utilization rates were 4.6%, 5.8%, and 5.1%, respectively, far exceeding the goals set for each of those states (2.5%, 1%, and 4.2%, respectively).

For these same 3 states, the percentage of care gaps closed among active members was remarkably high as well: 31% in Market 1, 71% in Market 2, and 76% in Market 3. Another notable result was the reduction in churn rate among engaged members in Market 1 and a fourth market: churn dropped by 76.13% in Market 1 and 84.54% in the fourth market.

Participation in the program also correlated to other high-value activities: members who completed an Annual Wellness Visit as part of the program were, on average, 3.2 times more likely to complete additional health care activities— leading to healthier members, increased risk identification and lower care costs.

With these exceptional results, the plan is now expanding with NovuHealth— introducing engagement programs into select Medicare markets—as well as launching new, member-satisfaction-focused programs.

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NovuHealth is the leading healthcare consumer engagement company, offering rewards and incentive programs that improve consumer health and plan performance. NovuHealth applies proven loyalty and data science strategies and leverages its deep industry and regulatory expertise to motivate high-value consumer activities. Headquartered in Minneapolis, NovuHealth has worked with nearly 40 health plans and served more than 15 million consumers across all 50 states.

Unlike the plan’s previous approach, NovuHealth leveraged predictive analytics and propensity modeling to target specific populations and deliver personalized communications.